A therapist writes notes with a pen on paper attached to a clipboard.

Jan Osborn, PhD, LMFT · Phoenix, AZ · Fair Oaks, CA

Helpful Forms & Client Intake

Downloadable new client intake paperwork, confidentiality policy, and records authorization forms for Jan Osborn Therapy in Phoenix, AZ and virtually in AZ & CA.

New Client Paperwork

Preparing for Your Initial Session

A light wood desk set with a notebook, black pencil, eyeglasses, and a white fluted vase.

0%

Confidential

Getting Started

Simple, Convenient Intake Process

If you're a new client, please complete the following forms and bring them to your first therapy session, or return them securely before your virtual appointment.

Completing these forms in advance allows us to devote our full session time to your goals, personal history, and healing work. If you would like me to coordinate care with another provider (such as your psychiatrist, primary care physician, etc.), please complete the Authorization to Disclose Information Form to authorize release of psychotherapy information.

icon

Complete in Advance

Filling out your paperwork prior to your appointment allows our first session to focus entirely on your care.

icon

Coordination of Care

Authorizing communication with your doctor or psychiatrist ensures collaborative, integrated healthcare.

icon

Strict Confidentiality

All documents and personal health information are protected under strict legal and ethical privacy standards.

PDF Intake Packets

Downloadable Client Documents

Click below to view and download the required forms for your appointment.

Client Psychotherapy Intake Form

Comprehensive intake questionnaire detailing your personal history, contact details, and initial counseling goals.

Limits of Confidentiality / Cancellation Policy

Detailed statement of client-therapist confidentiality, mandatory legal exceptions, and our 24-hour cancellation policy.

Authorization to Disclose Information Form

Release of information authorization to coordinate care with your physician, psychiatrist, or other healthcare professional.

Begin Your Care

Ready to Begin Your Therapy Journey?

Regardless of your past, you can create a new future. Download your forms and reach out today to schedule in Phoenix or virtually.

Call to Action Media

Office & Telehealth

In-Person in Phoenix & Virtual Throughout AZ and CA

Jan Osborn provides in-person therapy in Phoenix, Arizona, and virtual telehealth sessions for clients in Arizona and California.

Jan Osborn Therapy

Reach out to Dr. Jan Osborn for assistance with forms, scheduling, or care coordination.

Have Questions About Intake Paperwork?

Please complete this form to get in touch. We respect your confidentiality and ask that you do not submit sensitive medical records.

Your Name

Session Format

Email Address

Phone Number

Inquiry Topic

Your Message

Eucalyptus branches in a fluted ceramic vase displayed on a rustic wooden console table beside a white window curtain.

Having your paperwork ready ensures we make the absolute most of our very first session together.

Office Support